Hepatocellular Carcinoma in a Noncirrhotic Liver after Long-Term Use of Danazol for Hereditary Angioedema

Rahal, Soraya; Gilabert, Marine; Ries, Pauline; Oziel-Taïeb, Sandrine; Dermeche, Slimane; Raoul, Jean‐Luc

doi:10.1159/000370106

Cited by 11 publications

(9 citation statements)

References 7 publications

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“…In humans, danazol has been shown to have adverse effects, such as reversible liver damage and virilization [4, 5]. Although a causal relationship has not been conclusively established, some patients have developed hepatocellular carcinoma (HCC) after the administration of danazol [3, 6, 7, 15, 19, 22]. This report describes the development of HCC in a dog after chronic administration of danazol in addition to other immunosuppressive drugs, to induce remission of non-regenerative immune-mediated anemia (NRIMA).…”

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confidence: 99%

“…Although the relationship between administration of cyclosporine and development of HCC was reported in rats [11], it is not clear in humans, felines and canines. More importantly, there have been several reports of human patients developing HCC after administration of danazol [3, 6, 7, 15, 19, 22]. Although the effect of danazol on the liver is not completely clear even in humans, danazol is known to adversely affect liver enzymes, such as ALT and ALP, by elevating their levels [4, 5].…”

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confidence: 99%

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Development of hepatocellular carcinoma after long-term immunosuppressive therapy including danazol in a dog

Kobayashi

Miyama

Itamoto

et al. 2016

The Journal of Veterinary Medical Science

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A 2-year-old female beagle was referred to our hospital for evaluation of anemia. Laboratory tests, including bone marrow cytology, revealed non-regenerative immune-mediated anemia (NRIMA). Although initial immunosuppressive multi-drug therapy was not effective, additional administration of danazol was successful in treating the anemia. However, hepatocellular carcinoma (HCC) developed about 20 months after the administration of danazol. In humans, several cases of development of HCC after the administration of danazol have been reported. The present report describes a case of HCC development in a dog after chronic administration of danazol in addition to other immunosuppressive drugs.

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confidence: 99%

mentioning

confidence: 99%

Development of hepatocellular carcinoma after long-term immunosuppressive therapy including danazol in a dog

Kobayashi

Miyama

Itamoto

et al. 2016

The Journal of Veterinary Medical Science

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“…Undesired effects, among others, include an increase in body weight, menstrual irregularities, virilization, hepatotoxicity, and arterial hypertension. Liver cell adenomas and carcinomas have also been reported . Close monitoring is therefore routinely required.…”

Section: Long‐term Prophylaxismentioning

confidence: 99%

Prophylaxis in hereditary angioedema (HAE) with C1 inhibitor deficiency

Greve

Straßen

Gorczyza

et al. 2016

J Deutsche Derma Gesell

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SummaryHereditary angioedema (HAE) is a rare congenital disorder characterized by recurrent episodes of subcutaneous or submucosal edema. Laryngeal manifestations can be life-threatening. In the majority of cases, the disease can be adequately treated with an on-demand approach -in some cases, however, short-or long-term prophylaxis is indicated. Attenuated androgens used to be the drugs of choice, but they are associated with considerable side effects and no longer commercially available in the German-speaking countries of the EU. They are currently being replaced by more effective and more tolerable agents such C1-inhibitors, the kallikrein inhibitor ecallantide, and the B2 receptor antagonist icatibant, which have recently obtained market authorization. These new drugs have had a major impact, especially on the indications and procedures for long-term prophylaxis. According to the most recent international consensus papers and our own experience, self-administered C1-inhibitors are now the first option for long-term prophylactic therapy. The decision for prophylaxis should no longer be based on single parameters such as the frequency of attacks but on adequate overall disease control including quality of life. More drugs are currently being developed, which may lead to further changes in the treatment algorithms of HAE.

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“…Die unerwünschten Wirkungen umfassen unter anderem Gewichtszunahme, Menstruationsstörungen, Virilisierung, Lebertoxizität und Bluthochdruck. Über Leberzelladenome und –karzinome wurde ebenfalls berichtet . Eine eingehende Beobachtung ist daher regelmäßig erforderlich.…”

Section: Langzeitprophylaxeunclassified

Prophylaxe beim hereditären Angioödem (HAE) mit C1‐Inhibitormangel

Greve

Straßen

Gorczyza

et al. 2016

J Deutsche Derma Gesell

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ZusammenfassungDas hereditäre Angioödem (engl.: hereditary angioedema, HAE) ist eine seltene angeborene Erkrankung, die durch wiederkehrende Episoden subkutaner oder submuköser Ödeme charakterisiert ist. Kehlkopf-Manifestationen können lebensbedrohlich sein. In den meisten Fällen kann die Erkrankung mit einem On-Demand-Ansatz angemessen behandelt werden -in einigen Fällen ist jedoch eine Kurz-oder Langzeitprophylaxe angebracht. Attenuierte Androgene waren einmal das Standardmedikament; sie werden jedoch mit erheblichen Nebenwirkungen in Verbindung gebracht und sind in den deutschsprachigen Ländern der EU nicht mehr kommerziell erhältlich. Zurzeit werden sie von wirksameren und besser verträglichen Therapien wie C1-Esterase-Inhibitoren, dem Kallikrein-Inhibitor Ecallantid und dem B2-Rezeptorantagonisten Icatibant verdrängt, welche kürzlich auf dem Markt zugelassen wurden. Diese neuen Medikamente hatten einen erheblichen Einfluss, insbesondere auf die Indikationsstellung und das Vorgehen bei einer Langzeitprophylaxe. Nach den neuesten internationalen Konsenspapieren und unserer eigenen Erfahrung sind selbstverabreichte C1-Inhibitoren nun die erste Option bei der Langzeitprophylaxe. Die Entscheidung für eine Prophylaxe sollte nicht länger auf der Grundlage einzelner Parameter wie der Häufigkeit der Anfälle getroffen werden, sondern auf einer adäquaten allgemeinen Krankheitskontrolle, einschließlich der Lebensqualität. Zurzeit werden weitere Medikamente entwickelt, welche zu weiteren Veränderungen bei den Behandlungsalgorithmen des HAE führen könnten. SummaryHereditary angioedema (HAE) is a rare congenital disorder characterized by recurrent episodes of subcutaneous or submucosal edema. Laryngeal manifestations can be life-threatening. In the majority of cases, the disease can be adequately treated with an on-demand approach -in some cases, however, short-or long-term prophylaxis is indicated. Attenuated androgens used to be the drugs of choice, but they are associated with considerable side effects and no longer commercially available in the German-speaking countries of the EU. They are currently being replaced by more effective and more tolerable agents such C1-inhibitors, the kallikrein inhibitor ecallantide, and the B2 receptor antagonist icatibant, which have recently obtained market authorization. These new drugs have had a major impact, especially on the indications and procedures for long-term prophylaxis. According to the most recent

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Hepatocellular Carcinoma in a Noncirrhotic Liver after Long-Term Use of Danazol for Hereditary Angioedema

Cited by 11 publications

References 7 publications

Development of hepatocellular carcinoma after long-term immunosuppressive therapy including danazol in a dog

Development of hepatocellular carcinoma after long-term immunosuppressive therapy including danazol in a dog

Prophylaxis in hereditary angioedema (HAE) with C1 inhibitor deficiency

Prophylaxe beim hereditären Angioödem (HAE) mit C1‐Inhibitormangel

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